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Cooling Concussed Brain Cells Post-injury Staves Off Damage

This sounds like very preliminary work and the time and temperature behavior is complex, so I suspect it will take a lot of work to come up with a medical protocol, but it sounds interesting and promising.

Despite an immense amount of research, concussions and traumatic brain injuries (TBI) are still poorly understood. We understand the physical reason behind why they occur, but not how to treat them nor the underlying cellular mechanisms at play. Thus, diagnosis of concussions and TBI are difficult and sometimes unreliable.

...

Regardless, researchers at University of Wisconsin-Madison have exploited this minimal knowledge, leading a study that, for the first time, defines critical parameters for therapeutic hypothermia as a possible treatment for TBI. Literature on therapeutic hypothermia has provided conflicting information previously so this study, published in PLOS One, establishes a pivotal foundation to inform future animal, pre-clinical and clinical studies.

Christian Franck, UW-Madison professor of mechanical engineering, and colleagues at Brown University worked with a 3-D, in-vitro neural injury model in which the neural cells were encapsulated in collagen hydrogels. The researchers delivered a mechanical pulse to the model that simulates the injury and cell damage people typically experience with a concussion. Then, they cooled the injured cells to four different temperatures—37, 35, 33. and 31.5 C.

They found that 33 C (91.4 F) provided the most protective benefit for injured cells, while 31 C actually had a detrimental effect.
“Though only 1.5 C lower than the neuroprotective zone, the viability was far lower,” the researchers wrote in their paper. “Indeed, many other studies have shown evidence of deleterious effects when cooling below 32 C, consistent with our findings here.”

Beyond cooling, timing played a huge role in the research results. Through a series of tests, Franck and his team determined cooling should begin no more than four hours post-injury, and should continue for at least 6 to 12 hours, even all the way up to 24 hours. While cooling for even 30 minutes showed some benefits, starting treatment more than four hours after injury showed poor results.

Therapeutic hypothermia (TH) is an attractive target for mild traumatic brain injury (mTBI) treatment, yet significant gaps in our mechanistic understanding of TH, especially at the cellular level, remain and need to be addressed for significant forward progress to be made. Using a recently-established 3D in-vitro neural hydrogel model for mTBI we investigated the efficacy of TH after compressive impact injury and established critical treatment parameters including target cooling temperature, and time windows for application and maintenance of TH. Across four temperatures evaluated (31.5, 33, 35, and 37°C), 33°C was found to be most neuroprotective after 24 and 48 hours post-injury. Assessment of TH administration onset time and duration showed that TH should be administered within 4 hours post-injury and be maintained for at least 6 hours for achieving maximum viability. Cellular imaging showed TH reduced the percentage of cells positive for caspases 3/7 and increased the expression of calpastatin, an endogenous neuroprotectant. These findings provide significant new insight into the biological parameter space that renders TH effective in mitigating the deleterious effects of cellular mTBI and provides a quantitative foundation for the future development of animal and preclinical treatment protocols.

Back in my EMT days (early to mid 1980s), even then it was known that hypothermia was a way to at preserve brain function. For example, our rule for resuscitation of cold-water drowning victims, was that someone wasn't dead (stop the resuscitation) until they were warm and dead.

Yes that suggests non invasive treatments, like cold water bathing, could be used, maybe with vaso dilating drugs to make the blood flow in the skin where normally they close off.

sicut vis videre estoWhen we realize that patterns don't exist in the universe, they are a template that we hold to the universe to make sense of it, it all makes a lot more sense.Originally Posted by Ken G